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    Many Doctors Don't Report Incompetent Colleagues

    Survey Shows One-Third Don't Blow Whistle on Peers Who Are Impaired or Incompetent

    Why Not Report?

    When the doctors who didn't report impaired or incompetent colleagues were asked why, they gave a variety of responses:

    • 19% said they thought someone else was taking care of the problem.
    • 15% said they thought nothing would happen even if they did report the problem.
    • 12% said they feared retribution.

    Organizational Experts Weigh In

    The study results don't surprise Arthur Brief, PhD, the George S. Eccles Chair in Business Ethics and Presidential Professor at the University of Utah in Salt Lake City.

    In general, he says, "people don't speak out in the workplace. Fear of reprisal is a principal cause. In the case of physicians, that could be ostracization or reduced referrals."

    With the troubled economy, the fear of repercussions is probably greater, he says.

    The new results mirror those seen in whistle-blowing studies of federal workers, military employees, corporate employees, and internal auditors, says Janet Near, PhD, chairwoman of management and entrepreneurship of the Kelley School of Business at Indiana University in Bloomington.

    In her research, she has found the more egregious the wrongdoing, the higher the chance a worker would blow the whistle. "In the JAMA [Journal of the American Medical Association] study, a strong majority of physicians did blow the whistle when they observed wrongdoing, similar to the internal auditors whom we studied several years ago," says Near, who co-authored the book Whistle-blowing in Organizations.

    Putting It in Perspective

    The take-home for patients? "Don't freak out about this," says Matthew Wynia, MD, MPH, director of the Institute for Ethics at the American Medical Association, who wrote an editorial accompanying the study.

    The study finding "does not mean that bad doctors are rampant," he tells WebMD.

    "I am the last to say we have a perfectly safe health care system," he says. But reporting of colleagues is only one check on the health care system, he says.

    These days, he says, doctors are required to pass certification tests and get relicensed regularly in their practice area, providing more assurance of competency.

    Patients can take action, too, he says, if they suspect a doctor is impaired or incompetent. "Many hospitals and larger clinics will have a patient advocate or an ombudsperson, and that person might be a very good place to start if a patient thinks they might be dealing with an impaired or incompetent doctor."

    Another option, he says, is to contact the state medical board.

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